Pedia: Neonatology Flashcards
At what week of gestation is surfactant first synthesized? First appears in amniotic fluid? Reach mature levels?
20W
28-32W
35W
Treatment for recurrent apnea of prematurity
Theophylline or caffeine
Lowers threshold of response to hypercapnia;
Enhances diaphragmatic contractility;
Prevents diaphragm fatigue
Serious apnea is defined as cessation of breathing _____
Longer than 20s
Of any duration accompanied by cyanosis and bradycardia
Idiopathic apnea of prematurity resolves by ___
36W PCA
How does one differentiate CHD from pulmonary diseases as the underlying cause of cyanosis?
Hyperopia test.
PaO2 increases with pulmonary disease; not increased in cyanotic.
Management of biliary atresia
Kasai procedure
Do it before 8W (90% success)
Abdominal UTZ finding in biliary atresia
Triangular cord sign
How does one differentiate neonatal hepatitis from biliary atresia?
Neonatal hepatitis more common in premature; with a familial tendency.
Consistently pigmented stools rule against biliary atresia
Most common syndrome with intrahepatic duct paucity
Alagile syndrome
Kernicterus occurs in infants with a bilirubin level ___
20mg/dL
Jaundice is observed in how many % of term infants? Preterm infants?
60% of term;
80% of preterm
Indicators of pathologic jaundice
Appear within 1st 24 hours
Normal rate of increase 12 in full term; >14 in preterm
Persists after 10-14 days
Direct bilirubin fraction >2mg/dL
Most common location of Bochdalek’s hernia? Morgagni?
Bochdalek: posterolateral, left
Morgagni: antermedial, right
Triad of NEC
Intestinal ischemia
Bacterial translocation
Enteral nutrition
Indications for surgery in NEC
Evidence of perforation on X-ray
(+) result of abdominal paracentesis
